ROTH EA DPM - Podiatrist License in Illinois | # 135000981

ROTH EA DPM

Business Entity

EXPIRED

License Type

Podiatrist

Description

TEMPORARY PODIATRIC PHYSICIAN

License Number

135000981

License Status

EXPIRED

Business

N

Title

DPM

First Name

ROTH

Last Name

EA

Business Name

ROTH EA DPM

Original Issue Date

06/22/2017

Effective Date

07/01/2017

Expiration Date

07/01/2020

State

IL

Ever Disciplined

N

LastModifiedDate

11/19/2020